- Abecassis, Audrey;
- Roders, Nathalie;
- Fayon, Maxime;
- Choisy, Caroline;
- Nelson, Elisabeth;
- Harel, Stephanie;
- Royer, Bruno;
- Villesuzanne, Camille;
- Talbot, Alexis;
- Garrick, David;
- Goodhardt, Michele;
- Fermand, Jean‐Paul;
- Burbridge, Mike;
- Arnulf, Bertrand;
- Bories, Jean‐Christophe
Chimeric antigen receptor T cells (CAR-T) have provided promising results in multiple myeloma (MM). However, many patients still relapse, pointing toward the need of improving this therapy. Here, we analyzed peripheral blood T cells from MM patients at different stages of the disease and investigated their phenotype and capacity to generate functional CAR-T directed against CS1 or B Cell Maturation antigen. We found a decrease in naive T cells and elevated frequencies of exhaustion markers in T cells from treated MM patients. Interestingly, individuals treated with daratumumab display elevated ratios of central memory T cells. CAR-T derived from patients at relapse show reduced in vitro expansion and cytotoxic capacities in response to MM cells compared to those produced at diagnosis. Of note, CAR-T from daratumumab treated patients display intermediate defects. Reduced anti-myeloma activity of CAR T cells from treated patients was also observed in a mouse model. Our findings suggest that T cell defects in MM patients, specifically during relapse, have a major impact on their capacity to generate efficient therapeutic CAR-T. Selecting naive or central memory T cell subsets to generate therapeutic T cells could improve the CAR-T therapy for MM.